Dental Health: TMJ and associated disorders

TMJ (temporomandibular joint) disorders are a complex array of problems associated with the jaw joint. They can range from clicking and noises to actual locking of the joint either open or closed. A person has a left and a right TMJ. The disorders of the joint are evaluated for both the left and right sides. This is the only place in a person’s body where one bone is hinged by two joints. The lower jaw bone is connected to the upper skull bone by the temporomandibular joints on both sides.

No one treatment can resolve TMJ disorders for every patient. It takes time to evaluate the joint and to deliver treatment in order to allow the joint to heal. If you suffer discomfort in the joint Dr. Mengedoth through the comprehensive examination can help you find a way to become comfortable once again.

What causes TMJ disorders? ⇓

There are many things that influence the health of the jaw joint either positively or negatively. Trauma or acute injury can lead to long term jaw joint problems. Micro trauma which is continual can also cause damage in the joints. Both acute trauma and micro trauma cause swelling or inflammation which can lead to damage of the cushion known as the “disk” in the joint. The disk can be worn unevenly, torn, or pushed out of its intended position by these traumas. Signs of TMJ disorders would include noise in the joints, limited opening of the mouth, inability to close down and touch the teeth completely, and a complex path of opening or closing of the jaw. Symptoms experienced by patients can range from just irritation from the noises, to severe pain associated with the dislocation of the joint.

Do you have a TMJ disorder? ⇓

1) Are you aware of clenching or grinding of your teeth?
2) Do you wake up with sore muscles in your face or head?
3) Do you suffer from frequent headaches?
4) Does the pain get worse in your face or joint when you squeeze the teeth together?
5) Does your jaw make clicking, popping, or grating noises when you open and close
6) Does your jaw lock open?
7) Does your jaw allow you to open wide?
8) Do you suffer from arthritis in any of your other joints?
9) Have you noticed a change in how your teeth fit together when you bite?
10) Is it uncomfortable or painful to bite off food and tear it with your front teeth?
11) Are any of your teeth sensitive, broken, chipped, loose, or worn?

The more of the questions a patient answers yes to the more likely there may be an underlying TMJ disorder which should be treated.

Treatment of TMJ disorders ⇓

The treatment of the disorder first involves getting the patient comfortable and able to live life without pain in the joint. After a thorough exam and diagnosis is made, Dr. Mengedoth will most likely prescribe medication to help control the muscle spasm and the pain associated with inflammation in and around the joint. He will also recommend the patient alter some of their self care in order to minimize trauma to the affected joint. Some of the self care treatments could include:

1) Stretching and exercising the jaw
2) Keeping your teeth apart when you are swallowing and eating
3) Modifying the diet to include softer foods and avoid hard or chewy foods
4) Application of hot and cold to the affected areas
5) Resting your jaw and avoiding repetitive motion
6) Being aware of your posture and how you are holding your jaw when you are awake.

Modification of the amount of stress in your life is also evaluated. Life changes are discussed and the accompanying stress from said changes may lead to the understanding of why an acute event began. Use of physical therapy at times is recommended as adjunctive care. Dr. Mengedoth will eventually guide the patient into therapy which would include fabricating an appliance for the patient to help reduce their underlying bite related problem. Each bite appliance or “splint” is custom designed for the patient to correct their individual problem. They are made for either night time or full time wear depending on where the patient is at in their disease process. The ultimate goal would be to correct the underlying bite related problem by balancing how the teeth hit and move over each other. Once the patient is comfortable on the splint it is wise to move toward making the teeth touch and function on one another the same way the teeth touch on the splint.

What about correcting the joint problem with surgery? ⇓

At times surgery may be the only way we are able to help a patient control their pain and problems. It is Dr. Mengedoth’s belief that surgery of the joint be the last treatment option for the patient when all other therapy has been unsuccessful. Once a joint is opened and operated on it will never be the same. Many times through occlusal therapy, the use of a splint and eventual changing of the bite, Dr. Mengedoth will effectively treat the disorder without having to go through surgery. Changing the bite could include balancing of the bite on the existing teeth (equilibration), orthodontic movement of the teeth (braces), and or restorative dental work. Depending on the condition and the patient’s expectations the correct option is chosen and treatment is planned for the patient.